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Orofacial Clefts: Our Experience in Two Suburban Health Facilities

Ogunmuyiwa Stella Aimiede*,Gbolahan Omoyosola Olalere,Olaosun Adedayo O,Sotannde Adeshola I

Background: There may be gross under-reporting of clefts in developing nations due to late and non-presentation. The aim of this study was to highlight the descriptive epidemiology of the cleft lip and palate cases managed at the Oral and Maxillofacial Surgery units of two secondary health facilities in southwestern Nigeria and the factors accounting for late presentation.
Methodology: A prospective, cross-sectional study with consecutive recruitment of consenting cleft patients on presentation at the facilities between July 2010 and February 2012. A questionnaire was used to collect patients’ data. The data was analyzed using SPSS version 17.0 (SPSS, Chicago, IL, USA) to present descriptive statistics.
Results: Sixty three patients participated: 27 males (42.9%), 36 females (57.1%). The median age was 8 years (age range 1 day to 41 years). In addition the age distribution was multimodal (modal ages: 1 year and 4 years). The male to female ratio was 1: 1.3. The most common type of cleft seen was unilateral cleft lip with or without palate (50.8%) while median cleft was the least common (1.6%). About 9.5% 0f the cleft cases were associated with congenital anomalies. Consanguinity was not found in any of the patients. Over 70% of the patients presented late for treatment with financial constraints being the most common reason for late presentation. Only 6.3% of the patients gave a family history of clefts. Only a third of those who had surgery were present at the third follow up visit.
Conclusions: Late presentation, poor compliance to follow up and poverty remain the great challenges to OFC repair services in developing countries. It is believed that increasing availability of OFC repair services, together with an increase in awareness campaigns, may help to resolve these issues. There is a need for well designed prospective studies in the developing world to assess the true burden of the entity.